A long-time critic of mainstream psychiatry, and of the recent
near-exclusive emphasis on the biological aspects of mental illness
in particular, Peter Breggin makes sure his voice is among the
many offering post-Columbine recommendations for the future of
America's children by writing Reclaiming Our Children: A Healing
Plan for a Nation in Crisis. Breggin is particularly disturbed
by the focus and recommendations of the first-ever White House
Conference on Mental Health, held two months after the Columbine
shootings in June 1999. Featuring the biologically-oriented director
of the National Institute of Mental Health (NIMH), Steven Hyman,
as well as laypersons such as Tipper Gore who agree with his views,
the conference, says Breggin, was simply "a public relations
event for biological psychiatry and especially for the use of
psychiatric drugs to treat all the emotional and behavioral problems
of our children-in effect, all of their individual suffering and
all of their conflicts with adults."

The new initiatives announced at the conference--$61 million for
the NIMH for clinical drug trials involving children as well as
a new nationwide program to train schools and communities to identify
and get mental health services to troubled children--are also
criticized by Breggin as a thinly disguised bonanza for biopsychiatry,
a gilt-edged invitation into a huge new market, as well as a renewed
governmental blessing for the use of medicine to achieve social
control. Continuing work he began in The War Against Children,
which focused on federal efforts to isolate a "violence gene"
in part by experimenting on inner-city children, and other books,
Breggin argues in Reclaiming Our Children against biological
reductionism and for a broader psychosocial approach to dealing
with troubled and sometimes violent kids.

Instead of viewing violent children as themselves the problem,
something he sees as roughly equivalent to blaming the victim,
Breggin offers an alternative vision, one that considers the extreme
violence of some American children as a cry for help for all of
America's children. The Eric Harrises and Kip Kinkels, Breggin
argues, are like the canaries in the mine, alerting us to how
poor conditions are for all children trying to grow up in contemporary
American society. The lure of biopsychiatry is that its emphasis
is on individual defects, in this case defects in the child, not
on parents who work ever-longer hours, get divorced, or fail to
provide consistent discipline or societal-level stressors such
as overcrowded schools that value quiet, calm children or racism
and poverty or violent entertainment. Ours is a society that is
geared toward the needs and pleasures of adults at the expense
of our children, Breggin argues; it requires radical restructuring
to become child-oriented and child-affirming.

On a more personal level, Breggin contends that his theory empowers
parents; even if they are not the source of the problem (although
Breggin characterizes many child-behavior problems as conflicts
between children and well-meaning but problematic adults, he goes
to great lengths to say that not all problems originate
with parents), they are the most important part of the solution.
Parents should look to make changes in themselves and their families
rather than hand all responsibility for helping their children
over to medical professionals and pills. This is not an easy solution
or one that earns profits for the mental health establishment
and drug companies, Breggin acknowledges; it is simply the most
effective and ethical one.

The first few chapters of Reclaiming Our Children are devoted
to analysis of the Columbine shootings and other school shootings
in the year leading up to it in places like Oregon, Mississippi,
and Kentucky, and a critical look at the federal government's
response. Breggin points out that it has been confirmed that several
of the child shooters, including Eric Harris, were already in
the mental health system and on psychotropic medications at the
time of their respective incidents; the medication status of the
other shooters is unknown because their medical records are still
sealed for privacy reasons. He notes that not one of the speakers
at the White House Conference on Mental Health mentioned that
the "identify-and-drug" strategy they were advocating
was already at work (or not working, some might say) in several
of the school shooting cases. Rather than continue with and expand
the status quo, Breggin suggests a new approach. He lists a series
of environmental stressors that he claims the biological approach
completely ignores: lack of meaningful adult relationships, conflict
and divorce between parents, physical and sexual abuse, death
of a sibling, violent entertainment, abuse by peers, legal and
illegal drugs, guns, and poverty, among others. Only by addressing
some of these larger-scale issues, rather than just medicating
individual children, Breggin argues, can we truly address the
problem of the growing amount of violence perpetrated by children.

The second and perhaps best section of the book lays out Breggin's
views on children and the problems they face growing up in modern
society. He uses case studies from his own private practice to
show how his methodology of convincing adults to change, not drugging
children, has been effective in changing the so-called "problem
child's" behavior, children biological psychiatry was convinced
needed years of drug therapy. He devotes chapters to his concepts
of "warrior children" and "critical intelligence."
Children are often better at seeing injustice and hypocrisy than
the adults around them, Breggin says, and they will sometimes
fight to the self-destructive death rather than give in to such
perceived injustices. Breggin's approach emphasizes the importance
of respect between all parties in human relationships; he treats
all parties as capable of rational dialogue, or in the case of
very young children at least capable of responding to rationally
devised behaviors. Philosophically, his views prioritize narrative,
context, the interrelatedness of all humans and the importance
of relationships over a reductionism of all mental problems and
anguish to biochemical interactions and the fitting of behavior
patterns into prefabricated diagnostic molds.

Breggin ends the book by identifying institutions and practices
he believes are in need of reform and suggesting appropriate changes.
He discusses the potential dangers of psychotropic drugs, including
studies suggesting that 4-6% of children being treated with Prozac
or similar drugs developed manic symptoms. (For more on this topic,
see Breggin's Toxic Psychiatry.)
Could some of these manias cross over into violence, the very
violence the prescribing of the drugs was meant to prevent, Breggin
asks? He cites some cases as examples, including one in which
Prozac was blamed by the adult perpetrator's doctor in a mass
shooting in 1989 in Kentucky that killed eight and injured twelve
more. Breggin also points out that some medications are being
routinely prescribed "off-label" to children; in other
words, their safety and effectiveness have only been tested in
adults.

Appropriately enough for a post-Columbine book, he also addresses
contemporary schools and youth culture. He calls for an end to
what he calls "school slavery"-hours of homework a night
for children as young as second grade and a relentlessly competitive,
test-driven environment-and school scapegoating, the adult-sanctioned
(or at least tolerated) culture of jocks and nerds, teasing and
humiliation that makes kids on the lower end of the social scale
feel like they must fight back. He holds some schools, such as
Thornton Friends in the Washington, D.C., suburbs, up as examples
and distills thirteen principles of a good school, including small
class and overall size, the embodiment and teaching of principles
(religious or otherwise), emphasis on self-motivation over competition
and test scores, and ensuring that every student has a meaningful
relationship with at least one teacher. Breggin ends the book
by suggesting similar ideals for the improvement of families.

While Breggin has long provided and continues to provide a valuable
counterpoint to the drugs-and-biology emphasis of modern mental
health research and treatment, he sometimes goes a bit overboard
in his attempt to make a point and/or make his nearly lone voice
heard. His credibility will suffer among many, for example, when
he insists that no child should be given psychotropic drugs.
Perhaps most, even the vast majority, can be treated without drugs,
but to use universal terms like "all" and "none"
is to invite trouble. At the same time, to suggest moving the
focus of treatment away from medication is to call for bold changes
in today's quick-fix obsessed, managed mental health care world.
Also, Breggin occasionally tries to use the same types of evidence
that he criticizes others for using. For example, he rejects as
speculation the idea differences in brain scans are evidence of
abnormal biology in the mentally ill because not enough is known
about how the hundreds of chemicals in the brain interact. In
the very next paragraph, however, he insists that it is not speculation
but fact that psychotropic drugs cause biochemical imbalances
by interfering with normal brain function. A hard argument to
make, if Breggin is right in claiming that we don't know what
"normal" is.

These criticisms are relatively minor, however. In Reclaiming
Our Children, Peter Breggin marshals arguments he has been
making for years in an attempt to oppose what he sees as a new
threat to America's children in the form of the White House Conference
on Mental Health. Like many others, he may have seen the post-Columbine
mood of the nation as a rare opportunity for positive change,
a chance to resist the growing medicalization of all of society's
problems. He may have overestimated the moment; even stricter
gun controls failed to pass in the wake of the school shootings.
One doubts, however, that this will deter Breggin from continuing
to fight the good fight for alternatives to individually-oriented,
biochemically-based solutions to the social problems of violence
and mental illness.

Lara Winner, M.A.,
is a doctoral candidate in philosophy with a concentration in
medical ethics at the University of Tennessee, Knoxville. She
is interested in mental health/mental health ethics both because
it is a traditionally underserved area of medical ethics and because
it can provide valuable insights into the interrelationship of
mind, body, and spirit.

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